This Multidisciplinary Clinical Research Center (PITT-MCRC) application requests the expansion of the clinical research component of the University of Pittsburgh Arthritis Institute. This proposal builds on the strong interdisciplinary research base in rheumatic and musculoskeletal diseases at the University of Pittsburgh and on the success of the Arthritis Institute over the past 8 years. The PITT-MCRC research base currently consists of 140 independently funded research projects from 67 Principal Investigators. Members of the PITT-MCRC research base have an outstanding record of established extramural funding and are currently supported by federal and non-federal grants in excess of $54 million (annual direct costs). The PITT-MCRC will support three clinical research projects that address highly important clinical problems, an Administrative Core, and a Methodology Core. The three clinical research projects involve the following disciplines: adult and pediatric rheumatology, computer science, health services research, health economics, minority health, geriatrics, and epidemiology. These projects are: Project 1 - Quantitative Outcome Measures for Juvenile Rheumatoid Arthritis (JRA);Project 2 - Disparity in Joint Replacement: Pathway to Intervention;Project 3 - Inflammation and Aging: Cytokines, Bone Loss, and Fracture in Older Women;and Project 4 - Image Guided Debridement of Articular Cartilage. The two Cores of the proposed PITT-MCRC will provide the infrastructure to: i) promote multidisciplinary clinical research in arthritis and musculoskeletal diseases, ii) provide study design and biostatistical support, iii) encourage the development of new methodologies, and iv) foster trainee and junior faculty education and development. In addition to the support that it will provide for the four clinical research projects included in the application, the PITT-MCRC will foster the continued growth and productivity of the clinical research programs in rheumatic and musculoskeletal diseases at the University of Pittsburgh.